Antithrombotische Therapie nach strukturellen kardialen Interventionen

Empfehlung der Arbeitsgruppe Kardiovaskuläre Hämostase und Antithrombotische Therapie (AG19) der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. (DGK) in Zusammenarbeit mit der Arbeitsgruppe Interventionelle Kardiologie (AG6) – AGIK und der Arbeitsgruppe Klinische Pharmakologie (AG22) der DGK

Antithrombotic therapy after structural cardiac interventions

Recommendations of the Working Group on Cardiovascular Hemostasis and Antithrombotic Therapy (AG19) of the German Cardiac Society (DGK) in cooperation with the Working Group on Interventional Cardiology (AG6, AGIK) and the Working Group on Clinical Pharmacology (AG22) of the DGK

Zusammenfassung

In den letzten Jahren finden strukturelle kardiale Interventionen zunehmend Anwendung in der klinischen Routine. Trotz der raschen Einführung und Weiterentwicklung dieser Techniken, ist die Evidenz für die optimale antithrombotische Therapie nach solchen Interventionen limitiert, da randomisierte Studien zum Vergleich verschiedener antithrombotischer Therapien für die meisten Einsatzgebiete fehlen. Diese Empfehlung fasst den gegenwärtigen Erkenntnisstand zusammen. Basierend auf den zur Verfügung stehenden Daten, werden Behandlungsempfehlungen formuliert, die Ärzten und ihren Patienten die Entscheidungsfindung erleichtern sollen.

Abstract

In recent years, structural cardiac interventions became an important part of cardiovascular medicine. Despite the rapid development and evolution of these interventional techniques, there is a significant lack of evidence regarding the optimal antithrombotic treatment strategy as randomized trials on this issue are missing for most of these interventions. Thus, this manuscript summarizes the current level of evidence. The listed recommendations are based on available data as well as expert opinion and aim to guide physicians in making decisions for the treatment of patients in this setting.

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Abbreviations

ACT:

Activated clotting time

ASD:

Atrialer Septumdefekt

ASS:

Acetylsalicylsäure

DAPT:

Duale antithrombozytäre Therapie

DGK:

Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V.

DRT:

Device-related thrombosis/Device-assoziierte Thrombose

LAAC:

Left atrial appendage closure/linker Vorhofohrverschluss

NOAK:

Nicht-Vitamin-K-antagonistisches orales Antikoagulans

OAK:

Orale Antikoagulation

PFO:

Persistierendes Foramen ovale

TAVI:

Transcatheter aortic valve implantation/Transkatheter-Aortenklappenimplantation

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Hochholzer, W., Nührenberg, T., Flierl, U. et al. Antithrombotische Therapie nach strukturellen kardialen Interventionen. Kardiologe (2020). https://doi.org/10.1007/s12181-020-00441-w

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Schlüsselwörter

  • Duale antithromboztäre Therapie
  • Orale Antikoagulation
  • TAVI
  • MitraClip
  • Okkluder

Keywords

  • Dual antiplatelet therapy
  • Oral anticoagulation
  • TAVI
  • MitraClip
  • Occluder